Monday, December 2, 2013

Krokodil...not so fast, my friends!

The krokodil paper that was published online in the American
Journal of Medicine has been withdrawn “temporarily” online.It is definitely an interesting turn of
events. Many scientists, including me, had questions when this paper was
originally published online.Let’s go
through a very brief list of observations and questions that other scientists (and I)had after review
of the originally accepted manuscript:

1.The manuscript consisted of terrible grammar,
punctuation, and sentence structure. Was this manuscript not proofread during
review?

2.The manuscript was received on September 19th,
revised on September 24th, and accepted for publication on the very
same day (September 24th).If
you consult the calendar, that is 3 business days from receipt of manuscript to
revision to acceptance.Highly unusual! Did the quick turnaround on the manuscript lead to errors during the review process? Was the review process really even effective?

3.The drug is described as “flesh eating”. This is
not accurate and I would expect highly trained physicians to accurately
describe a drug and its effects in scientific literature. The drug,
desomorphine or its derivatives, does not cause the necrotic effects.The usage of this sensationalism is merely
perpetuating the media hysteria around this drug.

4.The manuscript states that the drug is spreading
rapidly around Europe. There is no scientific evidence to this claim. And actually, there is no evidence for the drug outside of some Russian countries.

5.A TIME article is cited as a scientific
reference. Since when did an online magazine article become a scientific
resource on the emergence of drugs in society? Is it peer-reviewed? No, I don't think so.

6.No toxicology, not even a routine urine drug
screen, is discussed in the manuscript.Major
flaw! Was there even an opiate detected in this patient's biological specimens?

7.The authors conclude that because opiates are
prevalent in the USA, krokodil will find its place among drug users.This is a baseless claim. Krokodil use in the
USA is illogical for many reasons, including the prevalence of cheap heroin, the
prescription controls on codeine, the prevalence of other prescription opioids,
harm reduction programs such as clean needle programs, as well as the
prevalence of treatment programs using methadone and buprenorphine.
That's not to say that some drug user would try to home-brew some krokodil - never say never when it comes to drug users, but it is simply illogical. And to say anything else is absurd.

I’m sure there will be more to report on this paper withdrawal.

Until then, there is still NO (zero, nil, zilch, nada, none) evidence that supports
krokodil is here in the United States.